Why PrEP?

PrEP can protect you from getting HIV.

Other methods of protection against HIV are:
· never fuck
· only fuck people when you are 100% sure they do not have HIV
· only fuck people with HIV who have an undetectable viral load (= less than 200 virus particles per milliliter blood)
· always use a condom when fucking

The question you need to ask yourself is: am I at risk for contracting HIV? Be honest with yourself.

Is PrEP for me?

PrEP is for every­body. For straight, gay, and bi+, for men and women, cis, trans, and non-bina­ry. There how­ev­er are dif­fer­ences in how to use PrEP:

Men and oth­er peo­ple who have a penis take 2 pills on the first day and then 1 pill every 24 hours. You are pro­tect­ed against HIV start­ing two hours after the first dose. If you want to stop using PrEP, you should keep tak­ing your pills until 48 hours after the last time you had sex with­out a con­dom. It’s also pos­si­ble to take only 1 pill on the first day; if you do that, then you are pro­tect­ed against HIV after using PrEP for 5 days.

Women and oth­er peo­ple who have a vagi­na take 1 pill on day one and then 1 pill every 24 hours. Because PrEP takes a longer time to pen­e­trate the vagi­nal tis­sue lin­ing, you are pro­tect­ed against HIV after 7 days. If you want to stop using PrEP, you should keep tak­ing pills for 7 days after the last time you had sex with­out a con­dom.

The advantages of PrEP

No more fear for HIV

No feel­ings of guilt if you do not use a con­dom time to time

A more enjoy­able sex­u­al expe­ri­ence

More con­fi­dence in your own actions

Nev­er depen­dent on some­one else’s con­dom use

Pro­vid­ed you get test­ed for STD’s every 3 months: if you con­tract an STD you will be treat­ed right away

Whether you should use PrEP is a per­son­al choice. It is a good idea to be well-informed when you make this choice. There are many dif­fer­ent con­sid­er­a­tions, but two impor­tant ones are: how impor­tant is it to stay HIV-neg­a­tive? And, what are the odds that I would con­tract HIV?

Why avoid getting HIV?

Nowa­days there are very good treat­ments for HIV avail­able, and usu­al­ly you only need to take one pill per day. Most peo­ple do not expe­ri­ence side effects from this med­ica­tion, and they will live rough­ly as long as some­one who does not have HIV. HIV-pos­i­tive peo­ple who have an unde­tectable viral load (less than 200 virus par­ti­cles per mil­li­liter blood) can­not trans­mit HIV to oth­ers.

Still, it is bet­ter to avoid con­tract­ing HIV, because:

You HAVE to take pills every day for the rest of your life. With PrEP, you can stop when­ev­er you want.

A lot of peo­ple with HIV expe­ri­ence stig­ma.

If you do not start in time with HIV treat­ment, you could get AIDS.

Your health at a lat­er age can be worse if you have an HIV infec­tion that remains untreat­ed for a long time.

You can trans­mit HIV to your sex­u­al part­ners, which can cause harm to your part­ners’ health.

Risk of contracting HIV through ‘gay sex’

In 2017, 7 out of 10 recent HIV infec­tions were found in men who have sex with men, and trans women who have sex with men.

In The Nether­lands, around 1 out of 10 men who have sex with men have HIV.
If you are a man or trans woman who has sex with men, you are at high risk of con­tract­ing HIV.

As a man who has sex with men it is a good idea to use PrEP, unless:

You ALWAYS use a con­dom when fuck­ing, includ­ing with your reg­u­lar part­ner

You do not always use a con­dom but you are 100% sure that your sex­u­al part­ner is HIV-neg­a­tive and is not at risk of con­tract­ing HIV from anoth­er sex­u­al part­ner

You do not always use a con­dom but you know that your sex­u­al part­ner has HIV with unde­tectable viral load. Some­one who has an unde­tectable viral load (= less than 200 virus par­ti­cles per mil­li­liter blood) can­not trans­mit the virus.

Risk of contracting HIV through ‘straight sex’

3 out of 10 HIV diag­noses in the Nether­lands are giv­en to women and men who only have straight sex. Since there are many more women and straight men than men who have sex with men, the risk of con­tract­ing HIV in the Nether­lands as a woman or straight man is very low.

As a woman or man who only has sex with women, you do not need to use PrEP, unless for exam­ple:

You are a woman who has sex with a man who also has sex with men.

You have sex with peo­ple in or from a coun­try where HIV is very preva­lent (for exam­ple in parts of south­ern Africa or South-East Asia).

You are a sex work­er and you do not always use con­doms.

Your part­ner has HIV with a detectable viral load. Some­one who has an unde­tectable viral load (= less than 200 virus par­ti­cles per mil­li­liter blood) can­not trans­mit the virus.

Risk of contracting HIV as trans

Unfor­tu­nate­ly, there is lit­tle infor­ma­tion avail­able about the risk of con­tract­ing HIV as a trans woman or trans man in the Nether­lands. In oth­er parts of the world (such as in the Unit­ed States) this chance is con­sid­ered to be high.

It all comes down to who you have sex with. Our advice is to read the last few chap­ters about ‘gay sex’ and ‘straight sex’ and to fol­low your own judge­ment. Also when it comes down to tak­ing PrEP or not. For this read “How do I take PrEP?”

For the sake of clar­i­ty in the chap­ters ‘gay sex’ and ‘straight sex’ we chose not to use inclu­sive lan­guage, for which we offer our sin­cer­est apolo­gies.

Talking to people who already use PrEP

On Face­book you can become a mem­ber of the Face­book group #PrEP­Nu. This is a closed group: only mem­bers can see who else is a mem­ber of the group, and only mem­bers can read and par­tic­i­pate in the con­ver­sa­tions.